Urine biomarkers for the prediction of mortality in COVID-19 hospitalized patients
Risk factors associated with severity and mortality attributable to COVID-19 have been reported in different cohorts, highlighting the occurrence of acute kidney injury (AKI) in 25% of them. Among other, SARS-CoV-2 targets renal tubular cells and can cause acute renal damage. The aim of the present...
| Autores: | , , , , , , , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2021 |
| País: | España |
| Recursos: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | inglés |
| OAI Identifier: | oai:docusalut.com:20.500.13003/18451 |
| Acesso em linha: | https://hdl.handle.net/20.500.13003/18451 |
| Access Level: | acceso abierto |
| Palavra-chave: | Area Under Curve Aged Adult Critical Care Humans Observational Studies as Topic Middle Aged Prognosis Hospitalization Male Severity of Illness Index Biomarkers Acute Kidney Injury Female Risk Factors COVID-19 ROC Curve Urine Logistic Models Retrospective Studies Modelos Logísticos Lesión Renal Aguda Biomarcadores Orina Femenino Estudios Observacionales como Asunto Hospitalización Masculino Factores de Riesgo Humanos Persona de Mediana Edad Cuidados Críticos Pronóstico Anciano Índice de Severidad de la Enfermedad Estudios Retrospectivos Adulto Área Bajo la Curva Curva ROC |
| Resumo: | Risk factors associated with severity and mortality attributable to COVID-19 have been reported in different cohorts, highlighting the occurrence of acute kidney injury (AKI) in 25% of them. Among other, SARS-CoV-2 targets renal tubular cells and can cause acute renal damage. The aim of the present study was to evaluate the usefulness of urinary parameters in predicting intensive care unit (ICU) admission, mortality and development of AKI in hospitalized patients with COVID-19. Retrospective observational study, in a tertiary care hospital, between March 1st and April 19th, 2020. We recruited adult patients admitted consecutively and positive for SARS-CoV-2. Urinary and serum biomarkers were correlated with clinical outcomes (AKI, ICU admission, hospital discharge and in-hospital mortality) and evaluated using a logistic regression model and ROC curves. A total of 199 COVID-19 hospitalized patients were included. In AKI, the logistic regression model with a highest area under the curve (AUC) was reached by the combination of urine blood and previous chronic kidney disease, with an AUC of 0.676 (95%CI 0.512-0.840; p = 0.023); urine specific weight, sodium and albumin in serum, with an AUC of 0.837 (95% CI 0.766-0.909; p < 0.001) for ICU admission; and age, urine blood and lactate dehydrogenase levels in serum, with an AUC of 0.923 (95%CI 0.866-0.979; p < 0.001) for mortality prediction. For hospitalized patients with COVID-19, renal involvement and early alterations of urinary and serum parameters are useful as prognostic factors of AKI, the need for ICU admission and death. |
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